Provider Demographics
NPI:1609917624
Name:DOUR, SENJA M (RDH)
Entity Type:Individual
Prefix:MS
First Name:SENJA
Middle Name:M
Last Name:DOUR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:SENJA
Other - Middle Name:M
Other - Last Name:TRIPLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:PO BOX 3835
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-3835
Mailing Address - Country:US
Mailing Address - Phone:206-548-3114
Mailing Address - Fax:206-762-6355
Practice Address - Street 1:525 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5101
Practice Address - Country:US
Practice Address - Phone:360-456-8844
Practice Address - Fax:360-491-4045
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00005247124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist